What causes capsular contracture after breast implant augmentation

Capsular Contracture is commonly referred to as “hardening of the implant”, but it this is a total misnomer. There is normally a soft capsule that forms around a breast implant, but when this capsule becomes thickened and hard, it is considered abnormal and is called Capsular Contracture or CC. CC will essentially “squeeze” the underlying breast implant. There are varying severities of CC and can range from simply slight hardening to a painful and grossly distorted breast implant. The treatment is very difficult and complex so much like anything, the key is prevention.

For a very long time, Plastic Surgeons told patients something like this – “capsular contracture is abnormal scar tissue that some people’s body makes. There is no way of knowing if it will happen and really depends on your body”. This was a great way to not take any responsibility for this dreaded complication that can occur in around 7% of women. My opinion is that this is an inaccurate way of portraying CC and is nothing more than a cop-out so that the surgeon does not have to take responsibility if CC develops. It also totally disregards current scientific evidence.

CC is an inflammatory response to some stimulus. This may be a small amount of bacteria and infection, blood from poor control of bleeding during surgery, powder from surgical gloves, or even lint from operating room towels. Basically, anything that irritates the body during breast implant insertion can make CC more likely. In fact, many of us believe that 80% of CC is the direct result of these causes, which means that 80% of the cases of CC should be avoidable. This leaves the other 20% to the mysterious “some-people’s-body-makes-bad-scar-tissue” theory.

There are some very specific techniques that some surgeons employ during surgery to minimize the chance of developing CC – “no-touch” technique, Keller Funnel, triple antibiotic implant irrigation, avoiding towels with lint, and using powder-free surgical gloves. I think that the data will eventually show a dramatic reduction in CC rates among those surgeons using these techniques. The bottom line is that is your surgeon tells you that CC is something that happens and cannot be predicted or prevented, then he/she clearly is not using these advanced breast implant insertion techniques.